Hyperhidrosis Medications

Description:
Another simple way to treat excessive sweating (focal or generalized) is the usage of a group of medications that are known as anticholinergic agents. Basically this group of medications act by blocking the neurotransmitter acetylcholine which plays a major role in sweat production. This group of medications was initially used for the treatment of ulcer disease where acetylcholine (the neurotransmitter) is playing a role in creating ulcers. The idea is that in very mild cases this could help in focal hyperhidrosis cases. There are different drugs in this group which are produced under different brand names.

Effectiveness of:
Even though those medications are sometimes used as the first line of treatment the effectiveness is very limited. Here again by continuous usage the body can develop resistance to these medications. Increasing the dose might also bring side effects such as blurry vision and dry mouth. This fact limited the use of this group of medication as an effective treatment modality. In cases of severe hyperhidrosis the effectiveness is limited and typically short lived.

Summary:
Anticholinergic agents which are cheap and easily available should be tried as one of the first conservative treatment modalities. It should be monitored by the patient and the physician for effectiveness in a trial period of about two to three weeks. Commonly prescription medications for this are Robinul, Propantheline and Ditropan. No specific recommendations can be given to either one of those.

For sure the pharmaceutical industry is working hard to provide appropriate solutions for excessive sweating issues. To be more precise very specific medications that will target the sweat glands have not been found yet to be very effective isolated palmar, plantar or axillary hyperhidrosis. All the available oral medications are derivatives of medications that treat other ailments without specifically targeting the sweat glands hence the success rate is obviously very limited. The other items on the market such as Iontophoresis machines (Drionic or RA Fisher) are also with limited success rates. Home made Iontophoresis machines are also possible to make but their success rate is very difficult to measure. The main the breakthrough will be obviously in the findings of a genetic solution. Since hyperhidrosis is not a malignant disease it doesn't attract the attention of the big pharmaceutical companies where the money needed to conduct such research lies.

My daughter, 17, has had this for several years and is about to go to college. she is horrified by the fact that she can be sitting in class and even her ponytail is wet! She plays competitive softball and I want to help her but am concerned about anticholinergics and the risk for heat stroke. what do you suggest?

I'm in my mid-40's & have been debilitated by hyperhidrosis since a child. (In order of degree of my severity: palms, feet, armpits.) It's horrible when all of a sudden you start sweating, for no apparent reason, and the anxiety that it causes increases the sweating rate (and it has a snowball effect).

Oddly enough, the medication for overactive bladder for frequent urination and urges has a wonderful side-effect of drying you out. Vesicare worked well for me, but it affected my mental recall and I got very cloudy (The 5mg dosage helped but 10mg really halted the sweating). I next went to Oxybutynin (at the 5mg dosage) but also got the cloudy sensation of not being able to recall things, but not as bad. I switched to Myrbetriq (new commercials advertise it on TV) but that didn't help the sweating at all for me -- there was no confusion but I also did not get any of the drying effects that I desired. I switched then to Detrol LA (Tolterodine Tartrate) -- while the confusion and drying effects were noticed, it was not nearly as good for preventing the sweating as Vesicare.

In the end, I have gone back to Oxybutynin (5mg tablet in the morning, and then another 5mg tablet before going to bed). Confusion caused by Vesicare for me was awful. AWFUL! At times I literally had to craft or formulate a sentence in that I couldn't recall words -- it was kind of like when a computer is buffering and you see the spinning wheel to tell you that's it "thinking.") I didn't go "brain dead" or couldn't say simple things like "I'm hungry" but it was very weird, kind of scary actually. Enough to where it affected my daily, personal and professional life. Changing drugs, however, helped with that.

All of this trial and error was suggested by my doctor. He said you may have to find the right one in this class of drugs, and there are a lot of them, but don't give up on this process. For my own sanity, I created a drug diary to keep up with the side effects and that's what I listed above.

Sidebar: I do use Drysal/Hypercare before going to bed at night. By itself, it did/does nothing. When combined with either Vesicare or Oxybutynin I believe it helps.

Ditropan/Oxybutynin is one of the anti-cholinergic drugs used in trials to control excessive foot and hand sweating. Some trials showed limited success rates but it can be tried. There are some side effects such as dry mouth or blurry vision but in small dosages the patient might not suffer from those. Again the response can be different from one person to the next.

I had tried ditropan but did not notice any change in excessive sweating. Mine is mainly in the uper section face and neck.is there any other choice or procedure? Had also tried the over the counters like certain dri and drysol. No help either. With ditropan the only thing i noticed is less frequency in urination.

As I wrote on my website on other pages I do not recommend ETS for the treatment of facial hyperhidrosis. You started in the right direction with Ditropan and if it does not help you at all then there are other medications you can try from that group (Robinul, Propantheline). You can talk with your physician to prescribe you those medications to see which one delivers the best results for you. Again ETS is not a solution for facial hyperhidrosis. Please refer to the other comments on this site along with our answers to those asking similar questions.

I find if you take the medicine in the morning, 1 and a half hours before eating anything, (best is to take about an hour before getting up, worth it if you have hyperhydrosis, just set an alarm, take and go back to sleep). This works amazingly well...... I think it helps with the absorption

If Avert is the same as Robinul then you are on the right track. Robinul/Avert is a medication that belongs to the anti cholinergic agents. There are others by the name of propantheline, ditropan and others. All of the medications from this group share a chemical activity that tries to block the activation of the sweat glands. The activation of the sweat glands is caused by a nerve impulse that produces an active ingredient (acetyl-choline). As the name of this group implies its action is to block the acetyl-choline active ingredient. The effect of this drug is not very specific. Having said that it does not mean that one should not try this group of medications. The side effects associated with this medication such as dry mouth or blurry vision should not be a problem if a patient does not take very high doses of the medications. It should be remembered also that with time the body will develop some resistance to those medications which might necessitate increased dosage. As long as the side effects are not bothersome then one can continue with this group of medication. It is not well established what long-term use can cause. And one should consult with a doctor/ pharmacist about long term use of this medication.

Hello I'm a 39yr old female and am on antidepressants, thyroid replacement meds and pain control meds. Every pill I take is on the list of causing excessive sweating. Sweating is on my back, head and face. The head and face are most bothersome. I've tried sweat shield wipes and haven't had much luck. I'm going to be a bridesmaid for a dear friend and need help. The wedding is in two weeks. How long do the oral meds take to start working? And can u recommend a fast acting medication? Please help me get this under control so I can enjoy this day for my friend.

Every medication taken by different people for different reasons can have side effects. Among those who are well known to do so are anti-depressants. Pain killers are also on the list. The exact mechanism is unknown. It is likely related to receptors which are influenced by those medications. We do not have a good answer for this problem of yours as of yet.

The oral medications that are available are from the group of anticholinergic agents such as robinol, propantheline and Ditropan. Before trying those you must consult your pharmacist with regard to any potential conflicts with the medications you are taking now.

I have had hyperhidrosis since 1999, many times I have thought of ending my life. I sweat from my head,face,neck, and recently I started sweating from the waist down. It is very embarrasing, since I work with the public. I can not wear makeup, I don't know what to do. Is Avert the same thing as Glycopyrrolate?.
I am at the end of desperation.

I'm in my mid-40's & have been debilitated by hyperhidrosis since a child. (In order of degree of my severity: palms, feet, armpits.) It's horrible when all of a sudden you start sweating, for no apparent reason, and the anxiety that it causes increases the sweating rate (and it has a snowball effect).

Oddly enough, the medication for overactive bladder for frequent urination and urges has a wonderful side-effect of drying you out. Vesicare worked well for me, but it affected my mental recall and I got very cloudy (The 5mg dosage helped but 10mg really halted the sweating). I next went to Oxybutynin (at the 5mg dosage) but also got the cloudy sensation of not being able to recall things, but not as bad. I switched to Myrbetriq (new commercials advertise it on TV) but that didn't help the sweating at all for me -- there was no confusion but I also did not get any of the drying effects that I desired. I switched then to Detrol LA (Tolterodine Tartrate) -- while the confusion and drying effects were noticed, it was not nearly as good for preventing the sweating as Vesicare.

In the end, I have gone back to Oxybutynin (5mg tablet in the morning, and then another 5mg tablet before going to bed). Confusion caused by Vesicare for me was awful. AWFUL! At times I literally had to craft or formulate a sentence in that I couldn't recall words -- it was kind of like when a computer is buffering and you see the spinning wheel to tell you that's it "thinking.") I didn't go "brain dead" or couldn't say simple things like "I'm hungry" but it was very weird, kind of scary actually. Enough to where it affected my daily, personal and professional life. Changing drugs, however, helped with that.

All of this trial and error was suggested by my doctor. He said you may have to find the right one in this class of drugs, and there are a lot of them, but don't give up on this process. For my own sanity, I created a drug diary to keep up with the side effects and that's what I listed above.

Sidebar: I do use Drysal/Hypercare before going to bed at night. By itself, it did/does nothing. When combined with either Vesicare or Oxybutynin I believe it helps.

I also have head, face, neck, and groin sweating! It is bad enough to have a completely wet head and top of shirt, but add in the look of wetting my pants and I am afraid to go anyplace I have to sit down. My underarms, feet, and hands are fine though.

What you are describing as well as what is described by other participants in this section. You have a certain type of hyperhidrosis which is focal / local in nature is unlike palmar and plantar hyperhidrosis. Sweating in those areas cannot always be explained by hyper sympathetic activity and more than that to isolate the specific segment of the sympathetic chain which is responsible for that is impossible to do. Short of conservative treatment with medications such as anticholinergic medications or local lotions there is no known specific therapy. Miradry which uses electro-magnetic waves to try to help with focal axillary hyperhidrosis might be used for groin sweating but the author has no experience with that.

Not knowing your age makes a full answer somewhat difficult to be given. You do not have the typical presentation for hyperhidrosis which is hands, feet and armpits. You described other areas on your body that not necessarily will be cured or helped with sympathectomy. Short of conservative treatments with pills, lotions and possible repeated Botox injections might give you some relief but I doubt it. Never the less you should try it. With regard to Avert I am not familiar with this medication so please consult your local MD.

I have generalized hyperhydrosis, being in a suicidal phase many times I found about these pills gave it a try and found that they work. I use Avert from Canada 2mg a day but am so scared about the future, since these pills are my last home and I am so scared because I choose not to live with this condition. They make me feel so normal I just want to know if anyone had success with it? How long you have been on the drug, dosage amount and general experience with the pills. Thank you!

Thank you for your question. I just want to make sure that when you are saying generalized hyperhidrosis you mean that you sweat from all over your body or is it just the hands and your feet? If it's all body then endoscopic thoracic sympathectomy is not the right answer. If you tried using anti cholinergic agents and it does provide some relief then you should continue with that. As we know, with time the effectiveness of those medications goes down and you might need higher doses. As long as you do not get severe side effects such as blurry vision or dry mouth then you can continue. No one has enough information about side effects after a very long term usage. If one type of anti cholinergic agents fails then there are few others on the market and you can try switching from one to another to find out which one is the best for you. I hope this sheds some light on your question. Good luck.

What is the recommended dosage form of propantheline for example or any other anticholinirgic drug in order to decrease the side effects as much as we can? Another question is that Robinul is an antimuscarinic but it's non selective , so is it accompanied with more adverse effects than the selective antimuscarinic one propantheline? The last question is , Ditropan (or Oxybutin) is available as transdermal patch for urinary urgency and incontinence, is this dosage form effective in treating hyperhidrosis?

Thanks for your question. The recommended dose for propantheline is 15 mg/day. You can increase the dose to 2 tabs/day if you do not have the side effects of dry mouth or blurry vision. Robinul basically is the same medication with an anti cholinergic action. None of them is very specific so you can try either and see what has the best results. The same goes for the ditropan, you can try the patch and check the results. Each patient will react in a different fashion. Please let us know your personal reaction. As always consult with your physician first. Dr. Reisfeld

Are prescription drugs always recommended to prevent sweating BEFORE endoscopic thoracic surgery? Are there documented success rates for Robinul VS ETS for truncal hyperhidrosis? Additionally, is compensatory sweating a risk with medicinal solutions just like it is with ETS? Thanks!

Conservative treatments with prescription drugs is always recommended before a patient embarks on surgical treatment. There are no documented success rates for Robinul for the treatment of focal hyperhidrosis. Basically speaking anti cholinergic agents such as Robinul do not produce compensatory sweating.